Today's economy has seen the bloom of the so called sharing-economy. Under traditional business models, businesses with large capital are able to bear the costs and infrastructure of providing services to consumers. Under the share-economy theory, individual consumers pool their resources and knowledge to provide similar services.
One industry that the share-economy has recently encroached upon is the loss mitigation and insurance industry. Under traditional insurance models, an individual wishing to protect himself from the risk of loss may pay a monthly premium to a high capital backed insurance company. If the individual experiences a covered loss during his coverage period, his insurance provider will cover all or a portion of his losses.
Under a share-economy risk pool, individual members seek to insure each other. Individuals in a pool will deposit funds into the pool, and if any member of the risk-sharing pool experiences a loss, the members will use the pool funds to cover the member's expenses. Members may find the risk-sharing pool attractive, as in many cases, risk pools can reduce costs by forgoing business overhead and staffing costs associated with a traditional insurance company.
Utilizing modern social networking and the wide spread access afforded by the internet, share-economy companies seek to provide risk coverage to a wide range of individuals that may otherwise not have traditional insurance coverage. Due to the flexibility of a shared-risk pool, members can insure losses for virtually any risk, granted there are enough members interested to insure the loss. Risk-sharing pools can now utilize the internet to expand their reach to increase the number of potential members globally, and members are no longer restricted to geographic communities.
In both the share-economy and traditional insurance realm, the costs associated with a loss can far exceed an individual's monthly premium or pool contribution. This creates an incentive for fraud and abuse. Under the traditional insurance model if a consumer experiences a loss, the individual will file a claim with his insurance company. A traditional insurance provider may then employ the services or a loss adjustor or loss assessor to determine the price and validity of the consumer's claims.
Under a true risk-pooling model, members can cut pool costs by not employing loss assessors. Additionally, by utilizing social media networks and the internet, risk sharing pools are able to connect members globally, making the hiring of trusted loss assessors prohibitively costly. For example, if individuals from around the globe form a risk-sharing pool, and a geographically isolated member files a claim with the pool, pool members may have to rely solely on the claimant or on an assessor of the claimant's choosing to determine the value of the claimed loss. This situation can lead to a perceived conflict of interest if not an actual conflict, and can cause members to become hesitant or lose confidence in the risk-sharing pool. In the share-economy industry, a member's confidence in the platform is paramount.
This application incorporates by reference U.S. patent application Ser. No. 15/122,611 ('611) filed Aug. 30, 2016, as if fully set forth herein. Patent Application '611 discloses a computer implemented method of creating peer-to-peer risk sharing pools. '611 discloses gathering members with like insurance needs and creating a risk-sharing pool in which the members each contribute funds to the pool to be used by members to recover from covered losses.
In light of the shortcomings in the prior art, there clearly exists a need for an improved method of adjudicating loss claims in a risk-sharing pool that minimizes fraud and increases the accuracy and efficiency of the pool.